In my career as a clinical service provider for Autistic young adults, I have seen how understanding the senses can impact one’s emotions. It is so important to be aware of how Autistic people learn, communicate, and think with all of their senses. Recently, The DSM-5TR has included “sensory symptoms” in the diagnosis of Autism Spectrum Disorder. In other words, it is a sensitivity to sounds, sights, smells, tastes, and textures (Patil & Kaple, 2023). There are many questions I urge clinicians, therapists, and multiple mental health service providers to consider relating to this when they work with Autistic People.
What is the environment of your office like? Are there peaceful but stimulating designs and colors? Are there items with soothing textures and sounds? What lights or moving items are in place? How do you communicate with those that you work with? Do you offer any visual components? Are there images or videos to explain what you are discussing with someone when you are speaking? How do people with Autism communicate with you when they are not audibly speaking? How are you communicating non-verbally with body language or other methods that they may be picking up on? I recently did a presentation at an event about teaching self-advocacy to Autistic young people. My favorite part was when a teenage boy and his mother approached me after the conference. The boy pulled out a tablet from his device. He wrote a message on his tablet to thank me for the presentation and to say that he related to what I spoke about. This message would have been lost if his mother or I focused on having him speak out loud at that moment. This is not to say that working with people on their audible speech) is wrong or unimportant (shout out to speech-language pathologists). I simply mean to convey that we must be attuned to people.
Movement can be another part of sensory processing or communication. Are the people you work with able to stand or move when they meet with you in your office? If you have experience with working with Autistic People, you may be familiar with the term “stimming.” Stimming refers to actions that are repetitive in motion and sound. Most experts agree that it is a response to sensory stimulation that serves to regulate their emotions (Rudy, 2023). Are you accepting of the sensory sensitivity yourself? Do you encourage Autistic people who you work with to embrace the idea that their sensory sensitivity may make them different from those who do not have Autism? The stigma in our society with this can be difficult.
Unfortunately, we also live in a world where actions related to sensory sensitivity may hinder the achievement of goals of Autistic people. In my humble opinion, this needs to be prioritized over changing how the world sees Autistic people. For instance, if someone wishes to go to college and obtain a job in an office setting after graduation, they will have to learn to manage constantly needing to move or shake their body. Stimming will likely not be possible in their college classes or in the office settings where they work. Should college administrative professionals and employers consider ways that they can be inclusive and accommodating to this? I would say absolutely! I firmly believe this, as I am fortunate to have the opportunity to provide training to colleges, universities, and businesses on this topic. The world should learn to accept people who act differently. However, clinicians providing services to Autistic people transitioning from childhood to adulthood should prioritize supporting a client’s goals as an individual. For instance, can the clinician work with their client to identify what causes the stimming? What purpose does it serve for them? Can the clinician suggest alternative strategies to regulate emotions that will work effectively in a college class or work setting if that is their goal? I was fortunate to receive training on Acceptance and Commitment Therapy (ACT), which utilizes this approach (Glasofer, 2024). ACT is an evidenced-based method of therapy (Gloster, 2020). I encourage all mental health professionals to learn more about it. I believe it is highly effective for those who are supporting Autistic people with the transition from childhood to young adulthood. ACT therapy focuses on accepting all emotions as they are experienced. ACT therapy also teaches people to make choices and decisions that align with their goals or values (Glasofer, 2024). In the transition from childhood to adulthood, the focus becomes more on your goals and values than those of your parents’ or guardians’ wishes. If mental health professionals help parents or family members identify this in childhood, ideally with early intervention to work on alternative strategies to stimming, they can begin the work ahead of time. Perhaps they can consider a new goal if this is impossible in adulthood. For example, they could consider a more hands-on career like a trade or job that requires a lot of moving. A goal related to one’s strengths can be more empowering than an unrealistic expectation.
Overall, sensory sensitivity can be helpful if it leads one toward one’s goal. However, it can be a detriment if it does not lead someone to the life that they want. Mental health service providers that use the ACT therapy approach can help people navigate it. I encourage them to receive training, education, or information on the methods.
Priya Winston, PhD, LMSW, is Director of Curriculum and Clinical Supports at Transitions.
References
Glasofer, D. (2024, January 16). What is acceptance and commitment therapy (act)?. Verywell Mind. https://www.verywellmind.com/acceptance-commitment-therapy-gad-1393175#:~:text=ACT%20therapists%20operate%20under%20a,can%20lead%20to%20further%20problems
Gloster A., Walder N., Levin M,, Twohig M., Karekla M. (2020). The empirical status of acceptance and commitment therapy: A review of meta-analyses. Journal of Contextual Behavioral Science, 18, 181-192, https://doi.org/10.1016/j.jcbs.2020.09.009
Patil, O., & Kaple, M. (2023). Sensory Processing Differences in Individuals With Autism Spectrum Disorder: A Narrative Review of Underlying Mechanisms and Sensory-Based Interventions. Cureus, 15(10), https://doi.org/10.7759/cureus.48020
Rudy, L. J. (2023). Why do autistic children stim?. Verywell Health. https://www.verywellhealth.com/what-is-stimming-in-autism-260034
